Foster Pet Caregiver Application

Foster Pet Caregiver Volunteer Application

* Indicates required field

Name *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

Phone Number *

Email *

I am at least 18 years of age: *

Beacon of Hope Crisis Center Foster Pet Program is very grateful to have foster families that are willing and able to provide necessities like food, toys, bedding, collars, and leashes for the pets in their care. If you are not able to provide these for your foster pets, reach out to the Director of Primary Prevention to see if extra supplies are available.

Why would you like to participate in this program? *

Have you ever been a foster pet caregiver? *

If yes, please provide details: *

Are you fostering for another agency? *

If yes, who are you fostering for? *

What types of animals are you willing to foster? *

If you answered other, please explain: *

If interested in fostering dogs, what size? *

What behavior potty-training issues are you not willing to take? *

What is your level of comfort administering medication to animals? *

Maximum number of pets willing to foster at one time? *

Please list your current pets, include their Names / Species / Breed / Sex / Spayed / Neutered / Age: *

Please list your veterinarian: *

Please list your veterinarian's clinic name: *

Please provide your veterinarian's phone number: *

Are your pets good with other animals? *

Are your pets kept primarily indoors? *

If not kept indoors, please explain: *

Do you have a fenced in yard? *

Do you work outside of the home? *

Please indicate your housing status: *

If you are renting, please provide your landlord's name and phone number: *

How many hours per day are your animals home alone? *

Where are your animals kept when you are not home? *

Where will you have foster animals kept when you are not home? *

Where will you have foster animals sleep at night? *

Do you have children in your household? *

If yes, please list their ages: *

If you answered yes, what interaction have they had with animals? *

Would you leave your children alone with a foster pet? *

Have the children in your home ever been bitten or had blood drawn by an animal? *

Please list (2) personal references whom we may contact: *

I have been visited or cited by an animal control agency in the last 24 months. *

If yes, please explain: *

Have you ever been convicted of a criminal case more serious than a minor traffic violation? *

If yes, specify date, charge, place and action taken: *

I hereby consent to the release of any record of criminal convictions by any law enforcement agency to Beacon of Hope Crisis Center (“BOHCC”) and any Health and Hospital Corporation of Central Indiana. I also consent to a background driving check for the purposes of establishing safe transportation for the animal(s).

Driver's License Number: *

I understand that if I am accepted into this program that I agree to undertake these obligations with no claim, now or in the future, to any type of compensation or reimbursement for caring of animal(s) in the Foster Pet Program. I agree that I will notify BOHCC of any additional animals that are added to my home, whether they are my property or part of another foster program, while I am providing care for a BOHCC client’s animal.

I further agree that accidental animal bites or other injuries to humans and other animals do occur, and agree to hold harmless and indemnify, and protect BOHCC, its staff, directors, officers, and volunteers, and partners, as well as the animal owner or agent, from any claim or suit filed by anyone as a result of such an incident. In addition, BOHCC will not be responsible if foster animals should damage or destroy property belonging to me, or shall transfer any disease or internal or external parasites to other animals belonging to me.

I certify that the information in this application is true. I understand that falsification of any information in this application can lead to my termination as a volunteer and that BOHCC and any Health and Hospital Corporation of Central Indiana may verify the information on this application. I will not hold any person or organization liable for releasing such information to BOHCC and any Health and Hospital Corporation of Central Indiana.

I attest my consent and certification *

Applicant's Signature

Applicant Printed Name: *

Date of consent, certification and submission of this application: *

Submit

Foster Pet Caregiver Volunteer Application

Main Office Line:(317)731-6131Crisis Call line:(317)731-6140

Main Office Line:
(317)731-6131

Crisis Call line:
(317)731-6140